CEO of United Healthcare gunned down in midtown Manhattan

[Hoopsdoc1978]

Funny poop story.

At IU freshman year. You know, good diet, clean living. The usual. Lived in Wilkie South (before the mixing of the genders, literally) and they were still building the Ed building. Cafeteria and dorm library were/are between the two towers.

Had a later archaeology or whatever class in Jordan Hall on the west side of campus. Walking back across the campus I feel the urge and then, horribly, the DROP. I'm approcahing the unfinished Ed building. Check doors. Locked. Shit (figuratively at this point). Now I gotta make a decision.

Can I make it to my room? No. Ruled out.
Can I make it to the tower lobby? Possibly.
What is the closest structure? The dorm caFeteria and library!!!!

But, a concern, it's like 8:30p. Are the doors locked? I've only got one shot at this b/c if those doors are locked I'm shitting in the bushes. So, I risk it. I'm full clench, waddling, strange gurgles from my abdomen, moistness between the cheeks. Pain.

Fellas, one of the best moments of my life was when that door to the dorm cafeteria/library opened but then.....FEAR. What if the bathrooms are locked. I might not even make it back outside and I might shit here in the atrium.

Run waddling to the bathroom and THANK JESUS the door open. I barely get my ass over the toilet before I release a torrent of foulness unmatched in my previous 19 years. I was drained and exhausted.

Threw my underwear away in the trashcan in the bathroom and hightailed it.

My oldest son has IBS and we didn’t realize it for years, being bad parents and all.

He would always have to go right after we got in the car and it drove me NUTS.

One day I refused to stop and the poor kid literally shit his pants. Looking back, that’s probably the low point of my life in terms of the things I feel bad about. I feel AWFUL about it now.

He’s always said it’s no big deal but I’m sure that episode will come up when he’s discussing how nice of a home to put me in.

 

[larsIU]

My oldest son has IBS and we didn’t realize it for years, being bad parents and all.

He would always have to go right after we got in the car and it drove me NUTS.

One day I refused to stop and the poor kid literally shit his pants. Looking back, that’s probably the low point of my life in terms of the things I feel bad about. I feel AWFUL about it now.

He’s always said it’s no big deal but I’m sure that episode will come up when he’s discussing how nice of a home to put me in.

My daughter's started with the "I guess we'll see what nursing home you're staying in when you get old" b/s.

Probably while she's on the iPhone we bought, on the plan we pay for, in the car we pay for, eating up the gas we bought.

However, I remember that I'm a sarcastic asshole and I often forget to turn it off and can be a little sharp on occasion. I'm trying.

Nohting pisses you off more than your own damn kids (especially teenagers).

 

[BadWakeboarder]

you can't do cologuard if you have had a history of polyps or are "high risk"

gonna have to bend over

I don’t think you bend over. If your doctor is making you do that, he must really really be into you.

 

[Thyrsis]

Funny poop story.

At IU freshman year. You know, good diet, clean living. The usual. Lived in Wilkie South (before the mixing of the genders, literally) and they were still building the Ed building. Cafeteria and dorm library were/are between the two towers.

Had a later archaeology or whatever class in Jordan Hall on the west side of campus. Walking back across the campus I feel the urge and then, horribly, the DROP. I'm approcahing the unfinished Ed building. Check doors. Locked. Shit (figuratively at this point). Now I gotta make a decision.

Can I make it to my room? No. Ruled out.
Can I make it to the tower lobby? Possibly.
What is the closest structure? The dorm caFeteria and library!!!!

But, a concern, it's like 8:30p. Are the doors locked? I've only got one shot at this b/c if those doors are locked I'm shitting in the bushes. So, I risk it. I'm full clench, waddling, strange gurgles from my abdomen, moistness between the cheeks. Pain.

Fellas, one of the best moments of my life was when that door to the dorm cafeteria/library opened but then.....FEAR. What if the bathrooms are locked. I might not even make it back outside and I might shit here in the atrium.

Run waddling to the bathroom and THANK JESUS the door open. I barely get my ass over the toilet before I release a torrent of foulness unmatched in my previous 19 years. I was drained and exhausted.

Threw my underwear away in the trashcan in the bathroom and hightailed it.

What year were you in Willkie?

 

[Bulk VanderHuge]

Shhhhh. I want to get lars to poop in a box.

 

[dr.jb]

Funny poop story.

At IU freshman year. You know, good diet, clean living. The usual. Lived in Wilkie South (before the mixing of the genders, literally) and they were still building the Ed building. Cafeteria and dorm library were/are between the two towers.

Had a later archaeology or whatever class in Jordan Hall on the west side of campus. Walking back across the campus I feel the urge and then, horribly, the DROP. I'm approcahing the unfinished Ed building. Check doors. Locked. Shit (figuratively at this point). Now I gotta make a decision.

Can I make it to my room? No. Ruled out.
Can I make it to the tower lobby? Possibly.
What is the closest structure? The dorm caFeteria and library!!!!

But, a concern, it's like 8:30p. Are the doors locked? I've only got one shot at this b/c if those doors are locked I'm shitting in the bushes. So, I risk it. I'm full clench, waddling, strange gurgles from my abdomen, moistness between the cheeks. Pain.

Fellas, one of the best moments of my life was when that door to the dorm cafeteria/library opened but then.....FEAR. What if the bathrooms are locked. I might not even make it back outside and I might shit here in the atrium.

Run waddling to the bathroom and THANK JESUS the door open. I barely get my ass over the toilet before I release a torrent of foulness unmatched in my previous 19 years. I was drained and exhausted.

Threw my underwear away in the trashcan in the bathroom and hightailed it.

thank God you didn't "miss your chance"

 

[larsIU]

What year were you in Willkie?

93/94

 

[larsIU]

thank God you didn't "miss your chance"

oh, I'm sure a janitor questioned his life choices later that evening.

 

[Lucy01]

As in 'deposition?' Really?

😢😢

 

[dr.jb]

oh, I'm sure a janitor questioned his life choices later that evening.

I've told this story before but it seems relevant again.....

lol, reminds me of a gig from a few yrs ago

We're playing a bar gig and all of a sudden about halfway thru the song i realize i can't hear the drummer....

I turn around and the drum kit is empty and think wtf? The rest of us look at each other bewildered and hastily wrap up, end the tune and announce we'll be taking a short break.

I go to the restroom to take a leak (small bar with just one stall) and discover a huge pile of wet, steaming $hit in one of the urinals. Back out to the stage where i'm relaying this new info to the rest of the band when the aforementioned drummer appears head down with a sheepish look on his face.

Turns out he overdid a beer/burrito combo beforehand and was really percolating......can't wait any longer and bolts for the john mid-song but some other dude is already in there so.....

We called him Uri from then on.

a fella has to watch what he mix and matches

 

[BradStevens]

Funny poop story.

At IU freshman year. You know, good diet, clean living. The usual. Lived in Wilkie South (before the mixing of the genders, literally) and they were still building the Ed building. Cafeteria and dorm library were/are between the two towers.

Had a later archaeology or whatever class in Jordan Hall on the west side of campus. Walking back across the campus I feel the urge and then, horribly, the DROP. I'm approcahing the unfinished Ed building. Check doors. Locked. Shit (figuratively at this point). Now I gotta make a decision.

Can I make it to my room? No. Ruled out.
Can I make it to the tower lobby? Possibly.
What is the closest structure? The dorm caFeteria and library!!!!

But, a concern, it's like 8:30p. Are the doors locked? I've only got one shot at this b/c if those doors are locked I'm shitting in the bushes. So, I risk it. I'm full clench, waddling, strange gurgles from my abdomen, moistness between the cheeks. Pain.

Fellas, one of the best moments of my life was when that door to the dorm cafeteria/library opened but then.....FEAR. What if the bathrooms are locked. I might not even make it back outside and I might shit here in the atrium.

Run waddling to the bathroom and THANK JESUS the door open. I barely get my ass over the toilet before I release a torrent of foulness unmatched in my previous 19 years. I was drained and exhausted.

Threw my underwear away in the trashcan in the bathroom and hightailed it.

I kept waiting for the part where you walked in and the girl you had been trying to hook up with all year was there watching you walk in or in the bathroom next to you and heard the whole thing.

And then I remembered: this is Lars's life, not mine.

 

[Lucy01]

Funny poop story.

At IU freshman year. You know, good diet, clean living. The usual. Lived in Wilkie South (before the mixing of the genders, literally) and they were still building the Ed building. Cafeteria and dorm library were/are between the two towers.

Had a later archaeology or whatever class in Jordan Hall on the west side of campus. Walking back across the campus I feel the urge and then, horribly, the DROP. I'm approcahing the unfinished Ed building. Check doors. Locked. Shit (figuratively at this point). Now I gotta make a decision.

Can I make it to my room? No. Ruled out.
Can I make it to the tower lobby? Possibly.
What is the closest structure? The dorm caFeteria and library!!!!

But, a concern, it's like 8:30p. Are the doors locked? I've only got one shot at this b/c if those doors are locked I'm shitting in the bushes. So, I risk it. I'm full clench, waddling, strange gurgles from my abdomen, moistness between the cheeks. Pain.

Fellas, one of the best moments of my life was when that door to the dorm cafeteria/library opened but then.....FEAR. What if the bathrooms are locked. I might not even make it back outside and I might shit here in the atrium.

Run waddling to the bathroom and THANK JESUS the door open. I barely get my ass over the toilet before I release a torrent of foulness unmatched in my previous 19 years. I was drained and exhausted.

Threw my underwear away in the trashcan in the bathroom and hightailed it.

Did you open your mouth so you wouldn’t vapor lock?

 

[larsIU]

Did you open your mouth so you wouldn’t vapor lock?

 

[Baller23Boogie]

wife wasn’t happy when I apparently told the nurse as (I was going out from anesthesia) that I was a grower not a show-er

Wife has surgery some years ago on her achilles. Everything went okay during surgery, they take me back to recovery which is basically a big ass room with curtains for separation.

Everything was fine and we are getting ready to get discharged. Nurse looked at me and said, you can go ahead and get her dressed.

I go to take off her gown so she can put on her hoodie she was wearing and without missing a beat, in her loud voice, says, stop looking at me pervert. Loud enough that I heard the nurses bust out laughing.

I've never been so embarrassed in my life. She claims to not remember it. There's a lot of things she can say to me, but that one got me.... I mean, I was trying to dress her, not remove more of her clothes.

 

[Baller23Boogie]

My daughter's started with the "I guess we'll see what nursing home you're staying in when you get old" b/s.

Probably while she's on the iPhone we bought, on the plan we pay for, in the car we pay for, eating up the gas we bought.

However, I remember that I'm a sarcastic asshole and I often forget to turn it off and can be a little sharp on occasion. I'm trying.

Nohting pisses you off more than your own damn kids (especially teenagers).

My kids have said my wife is going in one with Bingo, I'm going in one without a way out.

I wish they wouldn't have gotten my charm at times.

 

[mcmurtry66]

Maybe this will be an inflection point

The spotlight is on health insurance companies. Patients are telling their stories of denied claims, bankruptcy and delayed care.

People are speaking out about the issues they have faced with private health insurance in America, from thousands of dollars in bills to denial of coverage.

www.yahoo.com

 

[crazed_hoosier2]

Funny poop story.

At IU freshman year. You know, good diet, clean living. The usual. Lived in Wilkie South (before the mixing of the genders, literally) and they were still building the Ed building. Cafeteria and dorm library were/are between the two towers.

Had a later archaeology or whatever class in Jordan Hall on the west side of campus. Walking back across the campus I feel the urge and then, horribly, the DROP. I'm approcahing the unfinished Ed building. Check doors. Locked. Shit (figuratively at this point). Now I gotta make a decision.

Can I make it to my room? No. Ruled out.
Can I make it to the tower lobby? Possibly.
What is the closest structure? The dorm caFeteria and library!!!!

But, a concern, it's like 8:30p. Are the doors locked? I've only got one shot at this b/c if those doors are locked I'm shitting in the bushes. So, I risk it. I'm full clench, waddling, strange gurgles from my abdomen, moistness between the cheeks. Pain.

Fellas, one of the best moments of my life was when that door to the dorm cafeteria/library opened but then.....FEAR. What if the bathrooms are locked. I might not even make it back outside and I might shit here in the atrium.

Run waddling to the bathroom and THANK JESUS the door open. I barely get my ass over the toilet before I release a torrent of foulness unmatched in my previous 19 years. I was drained and exhausted.

Threw my underwear away in the trashcan in the bathroom and hightailed it.

That sounds like the guy who was about to check out of a hotel when he got hit by a major bowel attack. The lobby bathroom was occupied. So he ran back to his room and saw that his toilet had drained and the flush didn't work.

So he just went out into the room, found a potted plant, removed the plant from the pot, let it fly into the pot, and then stuck the plant and its soil back into the pot.

A week later he gets an email from the hotel. It said:


Dear Sir,

Thank you again for choosing the Days Inn Springfield. We hope that your stay exceeded all your expectations!

Sincerely,
The Management
P.S. All is forgiven and you are still welcome back -- but can you please tell us.....where is it?

 

[crazed_hoosier2]

Maybe this will be an inflection point

The spotlight is on health insurance companies. Patients are telling their stories of denied claims, bankruptcy and delayed care.

People are speaking out about the issues they have faced with private health insurance in America, from thousands of dollars in bills to denial of coverage.

www.yahoo.com

The problem isn't the insurance companies.

That's like putting Garbage In to software...getting Garbage Out from the software....and blaming the software.

 

[mcmurtry66]

The problem isn't the insurance companies.

That's like putting Garbage In to software...getting Garbage Out from the software....and blaming the software.

They are part of the problem. The entire system is broken. Fortune 500. #4 Uhc managed care. #6 cvs. #10 concora. #16 Cigna. #20 elevance managed care. #22 centene managed care.

3 of the top 10 largest rev companies in America and 6 of the top 25. Healthcare but none other than cvs sort of involved in the rendition of treatment. The cost of this managed care is absurd. From treatment to benefits mgmt bs like express scripts in pharm

 

[crazed_hoosier2]

They are part of the problem. The entire system is broken. Fortune 500. #4 Uhc managed care. #6 cvs. #10 concora. #16 Cigna. #20 elevance managed care. #22 centene managed care.

3 of the top 10 largest rev companies in America and 6 of the top 25. Healthcare but none other than cvs sort of involved in the rendition of treatment. The cost of this managed care is absurd. From treatment to benefits mgmt bs like express scripts in pharm

Well, of course they're part of the problem. But they aren't the cause of the problem. They're a symptom of it. An outgrowth.

But I don't think we're prepared to truly confront the root cause of the problem -- which all begins with the faulty and pervasive belief that healthcare is a basic human right.

 

[crazed_hoosier2]

They are part of the problem. The entire system is broken. Fortune 500. #4 Uhc managed care. #6 cvs. #10 concora. #16 Cigna. #20 elevance managed care. #22 centene managed care.

3 of the top 10 largest rev companies in America and 6 of the top 25. Healthcare but none other than cvs sort of involved in the rendition of treatment. The cost of this managed care is absurd. From treatment to benefits mgmt bs like express scripts in pharm

Consider this.

The BC/BS federation provides health insurance to some 120 million "belly buttons" (which is a term we use at our plan to distinguish an individual from a couple/family...which we call "doorbells").

Most of the BC/BS (last I looked, anyway) have not-for-profit status. Some of them are for profit. It's a mix, and I think the federation itself occupies kind of a unique spot in the tax code. It's a massive organization, or federation of organizations anyway.

Are they any better than UHC? Are the NFP affiliates of BC/BS more generous and accommodating than the FP affiliates?

The entire system is a mess. But it hasn't always been. It started becoming a mess in the late 60s and early 70s -- which, not coincidentally, is when the federal government started becoming the dominant presence in American healthcare.

 

[Marvin the Martian]

They are part of the problem. The entire system is broken. Fortune 500. #4 Uhc managed care. #6 cvs. #10 concora. #16 Cigna. #20 elevance managed care. #22 centene managed care.

3 of the top 10 largest rev companies in America and 6 of the top 25. Healthcare but none other than cvs sort of involved in the rendition of treatment. The cost of this managed care is absurd. From treatment to benefits mgmt bs like express scripts in pharm

I heard someone call insurance companies "rent seekers". I wonder why that wouldn't qualify. They don't provide care, they just inject themselves between patient and doctor. If we hadn't allowed insurance as a loophole around WW2 wage controls I wonder if we would ever have developed such a crazy system.

I wonder if the government carved out a catastrophic coverage, cover expenses above $10,000 in a year, and we eliminated all other insurance, if we could do better. We could probably find some way of doctors and hospitals providing care to Medicaid patients below market through incentives.

 

[mcmurtry66]

Well, of course they're part of the problem. But they aren't the cause of the problem. They're a symptom of it. An outgrowth.

But I don't think we're prepared to truly confront the root cause of the problem -- which all begins with the faulty and pervasive belief that healthcare is a basic human right.

Well, of course they're part of the problem. But they aren't the cause of the problem. They're a symptom of it. An outgrowth.

But I don't think we're prepared to truly confront the root cause of the problem -- which all begins with the faulty and pervasive belief that healthcare is a basic human right.

I think we can address the symptoms. Obviously a massive undertaking and again I hope we are soon at an inflection point. Other countries have done it. Managed care. In network out. Costs. An mri here averages about $2k. Around the world $500. I fckd my leg up. I need an mri and surgery. What’s the price. Well are you self pay no insurance emergency Medicaid, medicare, in network out of network. Hell sope can’t even get a referral. And these people at centene and places having BA,s from directional schools and make big bucks. The ceo $25 mil. Endless Dipshit vps working from home making half a mil a year. I know them personally

 

[mcmurtry66]

I heard someone call insurance companies "rent seekers". I wonder why that wouldn't qualify. They don't provide care, they just inject themselves between patient and doctor. If we hadn't allowed insurance as a loophole around WW2 wage controls I wonder if we would ever have developed such a crazy system.

I wonder if the government carved out a catastrophic coverage, cover expenses above $10,000 in a year, and we eliminated all other insurance, if we could do better. We could probably find some way of doctors and hospitals providing care to Medicaid patients below market through incentives.

I’m not smart enough to know how to reform this mess, but healthcare companies that don’t actually provide healthcare should not be 3 of the 10 highest rev cos in America. A 35 yr old with a b.a. from Webster university should not make more money at a managed care co than my ER DR buddy from a big ten med school at a major hospital

 

[crazed_hoosier2]

I heard someone call insurance companies "rent seekers". I wonder why that wouldn't qualify. They don't provide care, they just inject themselves between patient and doctor. If we hadn't allowed insurance as a loophole around WW2 wage controls I wonder if we would ever have developed such a crazy system.

I wonder if the government carved out a catastrophic coverage, cover expenses above $10,000 in a year, and we eliminated all other insurance, if we could do better. We could probably find some way of doctors and hospitals providing care to Medicaid patients below market through incentives.

They don't "inject themselves", they were put there.

Rent-seekers are basically those who take advantage of public policy incentives and regulations to make profits without any actual addition of value. In other words, they're absolutely to be expected when we ask the government to run markets. And, make no mistake, we have done that with healthcare -- because we believe that healthcare should be a right and we intuitively know that it won't be if it's all more or less run without regulation.

This began (largely) with the HMO Act of 1971.

I don't think it's inaccurate to call health insurers rent seekers. But I think the question we should be asking ourselves is why we ever thought it was a good idea to finance pretty much all healthcare by way of an insurance model. Years ago, people had hospitalization insurance for any kind of major need. But, for routine healthcare expenses, it was pretty well expected that we paid that out of pocket.

 

[mcmurtry66]

They don't "inject themselves", they were put there.

Rent-seekers are basically those who take advantage of public policy incentives and regulations to make profits without any actual addition of value. In other words, they're absolutely to be expected when we ask the government to run markets. And, make no mistake, we have done that with healthcare -- because we believe that healthcare should be a right and we intuitively know that it won't be if it's all more or less run without regulation.

This began (largely) with the HMO Act of 1971.

I don't think it's inaccurate to call health insurers rent seekers. But I think the question we should be asking ourselves is why we ever thought it was a good idea to finance pretty much all healthcare by way of an insurance model. Years ago, people had hospitalization insurance for any kind of major need. But, for routine healthcare expenses, it was pretty well expected that we paid that out of pocket.

Yes re your last paragraph

 

[dr.jb]

I heard someone call insurance companies "rent seekers". I wonder why that wouldn't qualify. They don't provide care, they just inject themselves between patient and doctor. If we hadn't allowed insurance as a loophole around WW2 wage controls I wonder if we would ever have developed such a crazy system.

I wonder if the government carved out a catastrophic coverage, cover expenses above $10,000 in a year, and we eliminated all other insurance, if we could do better. We could probably find some way of doctors and hospitals providing care to Medicaid patients below market through incentives.

there are many days when i can generate some serious hate/contempt for insurance companies

 

[mcmurtry66]

there are many days when i can generate some serious hate/contempt for insurance companies

Apply to law school. Good way to sate it

 

[Marvin the Martian]

They don't "inject themselves", they were put there.

Rent-seekers are basically those who take advantage of public policy incentives and regulations to make profits without any actual addition of value. In other words, they're absolutely to be expected when we ask the government to run markets. And, make no mistake, we have done that with healthcare -- because we believe that healthcare should be a right and we intuitively know that it won't be if it's all more or less run without regulation.

This began (largely) with the HMO Act of 1971.

I don't think it's inaccurate to call health insurers rent seekers. But I think the question we should be asking ourselves is why we ever thought it was a good idea to finance pretty much all healthcare by way of an insurance model. Years ago, people had hospitalization insurance for any kind of major need. But, for routine healthcare expenses, it was pretty well expected that we paid that out of pocket.

We put them there in WW2 to get around wage controls. We had issues before the 1960s. But so many people worked in factories and other jobs that provided insurance cheaply enough, they didn't notice it

But the people who didn't work those jobs probably did notice it. I recall my grandparents absolutely not wanting to see a doctor because they couldn't afford it. This would have been circa 1970 and Medicare, so it was just their memory of before.

 

[larsIU]

I wonder if the government carved out a catastrophic coverage, cover expenses above $10,000 in a year, and we eliminated all other insurance, if we could do better. We could probably find some way of doctors and hospitals providing care to Medicaid patients below market through incentives.

Years ago, people had hospitalization insurance for any kind of major need. But, for routine healthcare expenses, it was pretty well expected that we paid that out of pocket.

Yes please. Forced HSA to cover the high deductible planny nature of this model? Singapore esque?

 

[crazed_hoosier2]

I think we can address the symptoms. Obviously a massive undertaking and again I hope we are soon at an inflection point. Other countries have done it. Managed care. In network out. Costs. An mri here averages about $2k. Around the world $500. I fckd my leg up. I need an mri and surgery. What’s the price. Well are you self pay no insurance emergency Medicaid, medicare, in network out of network. Hell sope can’t even get a referral. And these people at centene and places having BA,s from directional schools and make big bucks. The ceo $25 mil. Endless Dipshit vps working from home making half a mil a year. I know them personally

I realize that most advocates of universal healthcare don't believe that we have universal healthcare. I would argue that we do -- but only that it's de facto not de jure.

But clearly many believe that universal healthcare means that people get the goods/services they need and don't get claims denied unless they're frivolous or superfluous. And I guess they're under the impression that public insurers (here or elsewhere) don't deny claims....only private insurers do that, which is why they have massive bottom lines and salaries.

What we can't get past -- what nobody can get past -- is the hard reality of scarcity. As great as it would be if this limitation didn't exist on something like healthcare (or other bare necessities like food and shelter), it does exist and it doesn't stop existing if we ignore it or just convince ourselves it isn't really there.

There will, always and everywhere, be a greater demand for this bundle of goods/services we call "healthcare" than there will by supply of them. As such, trying to implement a "right" to this is necessarily going to have some undesirable results. I say "necessarily" because we're trying to implement a fiction that can't actually exist. In single-payer countries, the primary undesirable result has been shortage (which manifests in the forms of delays and such). In our country, the primary undesirable result has been cost.

 

[Spartans9312]

I heard someone call insurance companies "rent seekers". I wonder why that wouldn't qualify. They don't provide care, they just inject themselves between patient and doctor. If we hadn't allowed insurance as a loophole around WW2 wage controls I wonder if we would ever have developed such a crazy system.

I wonder if the government carved out a catastrophic coverage, cover expenses above $10,000 in a year, and we eliminated all other insurance, if we could do better. We could probably find some way of doctors and hospitals providing care to Medicaid patients below market through incentives.

About the Health Center Program | Bureau of Primary Health Care

Overview of health centers, the impact of the Health Center Program, application and eligibility instructions, and the strategic partnerships that support the Bureau efforts.

bphc.hrsa.gov

Access to doctors and nurses vs “coverage” which is basically subsidizing insurance companies

 

[crazed_hoosier2]

Yes please. Forced HSA to cover the high deductible planny nature of this model? Singapore esque?

While I don't think Singapore's model would be the absolute ideal one, I do think it's probably the best one that approximates a "right" to healthcare that has ever been put into actual practice.

From what I've read about it (which has admittedly been back in the Obamacare era), they've struck the best overall balance between cost, quality, and availability.

 

[crazed_hoosier2]

I realize that most advocates of universal healthcare don't believe that we have universal healthcare. I would argue that we do -- but only that it's de facto not de jure.

But clearly many believe that universal healthcare means that people get the goods/services they need and don't get claims denied unless they're frivolous or superfluous. And I guess they're under the impression that public insurers (here or elsewhere) don't deny claims....only private insurers do that, which is why they have massive bottom lines and salaries.

What we can't get past -- what nobody can get past -- is the hard reality of scarcity. As great as it would be if this limitation didn't exist on something like healthcare (or other bare necessities like food and shelter), it does exist and it doesn't stop existing if we ignore it or just convince ourselves it isn't really there.

There will, always and everywhere, be a greater demand for this bundle of goods/services we call "healthcare" than there will by supply of them. As such, trying to implement a "right" to this is necessarily going to have some undesirable results. I say "necessarily" because we're trying to implement a fiction that can't actually exist. In single-payer countries, the primary undesirable result has been shortage (which manifests in the forms of delays and such). In our country, the primary undesirable result has been cost.

I referenced that Vermont article the other day -- and I think it demonstrates the difference between "I have health insurance" and "I have good and affordable access to healthcare goods/services".

Vermont has the highest coverage rate in the country. Yet accessibility is bad, costs are high, and more than half of the the state's hospitals are operating in the red....which, naturally, is something that can't go on forever.

 

[mcmurtry66]

I realize that most advocates of universal healthcare don't believe that we have universal healthcare. I would argue that we do -- but only that it's de facto not de jure.

But clearly many believe that universal healthcare means that people get the goods/services they need and don't get claims denied unless they're frivolous or superfluous. And I guess they're under the impression that public insurers (here or elsewhere) don't deny claims....only private insurers do that, which is why they have massive bottom lines and salaries.

What we can't get past -- what nobody can get past -- is the hard reality of scarcity. As great as it would be if this limitation didn't exist on something like healthcare (or other bare necessities like food and shelter), it does exist and it doesn't stop existing if we ignore it or just convince ourselves it isn't really there.

There will, always and everywhere, be a greater demand for this bundle of goods/services we call "healthcare" than there will by supply of them. As such, trying to implement a "right" to this is necessarily going to have some undesirable results. I say "necessarily" because we're trying to implement a fiction that can't actually exist. In single-payer countries, the primary undesirable result has been shortage (which manifests in the forms of delays and such). In our country, the primary undesirable result has been cost.

I’d argue in our country shortage is also an issue. And I don’t disagree with your post. Public would presumably deny service akin to private. Something less than 0.1 percent of private insurance denied claims are appealed. I suspect much of that is owing to ignorance but that’s an aside.

I again don’t disagree with what you write but it doesn’t speak to unnecessary bloat; unnecessary administration; a system that can be reformed to better provide care without unnecessary costs and administrative services baked in. We’re seeing it in real time, albeit in a small scale, with mark Cuban’s pharmacy

 

[Marvin the Martian]

I referenced that Vermont article the other day -- and I think it demonstrates the difference between "I have health insurance" and "I have good and affordable access to healthcare goods/services".

Vermont has the highest coverage rate in the country. Yet accessibility is bad, costs are high, and more than half of the the state's hospitals are operating in the red....which, naturally, is something that can't go on forever.

I always wonder about not-for-profits losing money. I knew of a case 25 years ago, a person ran a not-for-profit and a for profit. When the not-for-profit needed to have no profit, it hired him for a lot of consulting in his for profit capacity. When the for profit needed to shed some tax liability, money went the other way.

I would not be shocked to find the hospitals are only losing money due to some creative accounting.

 

[crazed_hoosier2]

I’d argue in our country shortage is also an issue. And I don’t disagree with your post. Public would presumably deny service akin to private. Something less than 0.1 percent of private insurance denied claims are appealed. I suspect much of that is owing to ignorance but that’s an aside.

I again don’t disagree with what you write but it doesn’t speak to unnecessary bloat; unnecessary administration; a system that can be reformed to better provide care without unnecessary costs and administrative services baked in. We’re seeing it in real time, albeit in a small scale, with mark Cuban’s pharmacy

Removing administrative bloat would obviously (and pretty much always) be a good thing. But we should also examine why it exists in the first place.

I believe strongly that the things we tend to look at as causes of the pain are actually symptoms of it. Treating symptoms is fine. But we shouldn't expect the problems to go away until and unless we address the root causes.

As I said, I just don't think we're prepared to do that. We'll endure almost anything in order to not have to give up the enchantment of the unicorn. And I get that -- because it's not as if I have no sympathy for it. I just think it would at least be helpful if more people understood this as the reason. Clearly, a lot of people blame corporate profits, rich doctors, rich insurance executives, rich medical device people, etc.

It's true that many people have made a lot of money in healthcare. There's nothing necessarily wrong with that. The Walton family made hundreds of billions by saving their customers money. But the glut we have in healthcare is a result of a choice we've made, not the cause of the pain we feel.

 

[crazed_hoosier2]

I always wonder about not-for-profits losing money. I knew of a case 25 years ago, a person ran a not-for-profit and a for profit. When the not-for-profit needed to have no profit, it hired him for a lot of consulting in his for profit capacity. When the for profit needed to shed some tax liability, money went the other way.

I would not be shocked to find the hospitals are only losing money due to some creative accounting.

Maybe. But, I have to say, I'm skeptical of that.

I don't work in healthcare. But I do have affiliation with a healthcare charity that (let's say) is pretty cross-pollinated. Through that, we do get some visibility into the finance side of the primary entity itself. One thing I'll say is that rural healthcare is an abject mess. They aren't hiding money, they're losing it....and many aren't going to be able to continue operating unless they're gobbled up and subsequently subsidized.

 

[dr.jb]

Apply to law school. Good way to sate it

no way. i'm a lover not a fighter.

i hate conflict

 

[crazed_hoosier2]

I always wonder about not-for-profits losing money. I knew of a case 25 years ago, a person ran a not-for-profit and a for profit. When the not-for-profit needed to have no profit, it hired him for a lot of consulting in his for profit capacity. When the for profit needed to shed some tax liability, money went the other way.

I would not be shocked to find the hospitals are only losing money due to some creative accounting.

BTW, the one I'm most familiar with...there is a mix of FP and NFP under the corporate shell. It's primarily NFP, though. And this one doesn't lose money.

Also, major healthcare orgs being as regulated as they are, being largely tax exempt, and relying on ~35-40% public dollars, it would surprise me to learn that their finances aren't closely scrutinized. That said, Bernie Madoff was supposedly closely scrutinized too...and he got away with his grift for decades.